HomeMy WebLinkAbout20166666 - Permit (2)Permit #: 20{66666
Pin #: 51446
Assessor'sParcel: 410-291-02 Lot: NA
Btdg:
Tract NA
Suate Range:
Zoning: R4
q
Owner:
Address
Contractor
Address:
Prime & South Coast L P
50 California St 920
San Francisco, CA 941114606
Western Plumbing Services
1810 N. Linwood Ave.
Santa Ana, CA 92705
(714) 492-5490
011'16002 51603
01116002 5160C
011 16002 51603
Amount
24.79
22.O8
55.04
Fee Type
Dedicated Circuit
General Plan Update
lssuance
Qty
2.00
1.00
1.00
Fee
$49.58
$22.08
$55.04Phone
Tenant Name:
utt
8/L4/211!g
Trons+:77
Ref+:- s/ t4/l.ttlv
Phone
State Lic #: '1021101
Lic Type: C-36
Bus. Lic #: 364095
Workers' Compensation lnsurance:Carrier: State Farm Fire and Casualty Company
Policy #: 90C6X6879
Expires: 0912412018
F.
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6enPro] F'1qn lJpdote Fee
it111600?- : r6utt(ttt(-
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{:(:+ : }}*rrrirrrr}37i3 Auth+rl
Planning Conditions
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Multi-Family (5 or more uni Occupancy:
Alteration Constr TYPe
washer/Dryer Closet Code:
Date:
Date:
Date:
U, R.2
VB
cEc 2015
Notes: Convert existing closet to washer/dryer.
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Zuniga, Allissa
Every parmit issued shall becofie invalid unless the tvork o, fho sile
authoized by such permit is conmencad within 180 days aftet its
issuance, or if the wod< authorized on the sile by such permit is susponded
or abandoned fot a period of180 days after the time the wo* is
commenced
$126.70
$0.00
$126.70
lnspector MID#: 2018-145397
01 1 16002 5'1600
01 1 16002 51603
$22.08
$104.62
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA,27O2 Electrical
Permit Counter: (714) 647-5800 lnspection Requests: (714\ 667-2738 lnspector Section: (714\ 647-5853
Project Address: 3822 S Flower St Unit; H
Block: NA
AddressRange: 3800-3928
Historic: No
IDI J6
2r r1,5r,
16 /1.r.:
Building Use:
Job Type:
Nature of Work:
0811412018
Account#
Fee Total
Paid to Date:
Balance Due:
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE ID/SIG.OWNER BUILDER DELC RATION
I h*cb, amrnr lnder Fnalt, oa !€rjrr, rhar I am cxcmfl fronr rhc ConrrrcroN l-iccnse liw f.r rhc nrkNin8 r.nsn (S.c 7011 5
Busi.css dnd Piore$ioi Codc): ]\ny C y or Coxdy whkh rcqut s d Fmit ro .on$fl.r. !ncr. inrm\c, dcmlht or rcItir !n,
(ruclurc, I'rior to ns issumc. ako rcqlncsrhc applicd for such ?cnnir to nlc a shmd (utcnEnr lharhorshc k liLtnsd ruhxanr
lo rh. rov(ions orrtE Co.kr.rors Lic.nsdl bw (chrflcr 9. connmRin8 wilh Scclion 7uD of Divnio.I ot rhc Blsi'rcs\ rnd
Pmfcsion\ Codc)orthal h.orshc h cxcnrfl IhcrcfroDnnd ltu hast for the !l lcBcd cxc n{'l ion AnyviololionofSerionT{rll.5bya.y
nptliconr aor o pcmit subjcck rhc optliclnl to rcililpcntrhyofml morclhan fivc hunnrcd dolh^ ($500).
-l.a\ownc.ofrheDropcny-ormycnrpby.c\$ilhsa8csaslhcirsolecoryrnsarion.willdorhcwolkrdlh.{u_turcismricnl.i.rofltddforslc(S.{104.1.Busi,rc$..dAor.s\n,n\CodcTh.Cofti.ktr\Lic.nsctiwdocsmtau,lyloaoowrcrof
rhc pmpcny who builG or inr()rc\ rh.E,.. aNl s hr des irrch Nolt hnnscll or ncr*ll or rhmust hh or hcr o*n c rployccs.
prolidcd rhar su.h tnimruEnrs m rr inr.Mcd or.rcdl rir qh If. hacv.r, rh. bxiHnE ur nNtuvcnrnl is bH *irhin onc )€r
oi.on{,krn,n. rh. O$ ncr Auil{ls qill h.v. rhc hordcn of ln,vin8 rhar hc or shc did nor hxild or inptuv. rhc lnrtMy for rhc t'urpos ol
I. d owncr or rhc pmprdy, nm e x.lu si v.lt ..nrir.r ing eirh li.enr.d $nlh.tns tu .otrslru.t tlE l,lFcl (Scc. ?0+4. R6in$\
afrl Pn,tssion Codc Thc Cotrraclor's Liccn\c Low docs not {fly nr u owns ol pmrEny sho hn ikl\ or imp.ov.l rturmn.
aM Nho co.limh ror such pmj(h wirh. conrm.rlds) li.cnse rur*urN r,rhc conractolr LiLTnsc hw).
l B,ncrcmpr uM.r Scclio
UIIBSESII;AIIIENSAIII)N
DSCI.A8AIA!
I hcrcby afflrm undf ,,.mlly of tdjury onc of lhe folbwing d.cLnlions:
I h.vc ar] willrEnnrin a Ccniticalc ofCons.n . Sclf Insorc {o. w.rkciq .onpcnsalion. rs rovidcd for hySccrion 37(Dolrhc
Labor Codc. for lhc lcrfonMncc of thc *ork aor *hich lhc psn l h issled
-l
hat &nd siu msinr0in so ers conpensarion iNlmncc. as requtcd hy secrn,n]700orllr ljh.r Cod., ior lhc PcrforroEc ol
rhc*.-ltnr*hEhrhhNrm:ri\i.\u.dMtworkchcomNntariolin\ursns,ori.dIslitndmb.rd.
."* - SJ-r.[., frr' r.-^,
? "ti".r N"^6
",
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I.c ily Ihrr n rh. Nrfoi,nrmc ofthc work ttr which rhi\ |Fi,n( n isndl.I shrll nor cnrliy trry pcr\otr i', rny mrtrncr
v' i, bcomc suhjLrr ro rhc workcri .o q, p.nsrr ion hw\ .f Crlir'orn ir- i rsrcc rhd irl nx,rld br.o'ft \uhjr{r t)rrx
$.rkcF.ompcnuli{,nptr)vi\i,,tr\otSccii,nrlT(xrofrhcl-atxtrC.dc.tnnlLfdhsirh(uPlywirlrrlr\cI)(,(Niotrs..
WARNINC l,trihtrc to s..^urc qorkcs'.omr.n$ridr coverusc is utrlawlul. llrd rhlll suhl.cr rlr cmnk,ycr h.ri inrlp.Mlrics 8trd
civil rinc\ u, ro nnc h!.drcd rhousrnd dollars (Sl(x )).ir{ irnnr ro rhc cod oi c{nnncns n,n, dr agcs.\ povid.d lnr thc
Sccrnnr 1076.llhc Llhor Codc. inlcrc{ and arktrEy
,.,",* 9.-\q-\b
I hcrcbyaffir undcr pcnalry.fr,.rjuryrh{ I a licctr\.d ntulc, Eovi\ion olChrprd 9{c.nmrn.ine wnh S..rion l{XX)) olDivnion l
ol lhc Busi.csand Proit$ions Code. and,ny licemc is in tull lorcc ond cnccr.
C6?\ 6-2I.t\ (
rur" n r9.\)
IOISIBIJ(:IION.LENDING.AGENCI
I hcrcty !fltmundcr pc"ahyofpcrjuryrhar lhcrc ha c.n(Nclion lcndins arcDcy i{n rh. prf.rrun orrhc s.rk lor which rhn Frnril is
isucd (Scc 1097, Civ C.)
AITIICANfIIECI.AAAIION
I lEtbyallmundcr pcnrlry oipcrjuryonc.f lhc followin8 d(larution\:
Dcnrlirnn P.rmirs Asb.{os Noriicarion Fcdcrul R.euk n,ns (_tillc 40. P,n6)
R.quind trn* orNodi.dion
I ccnilyrhlr thc rcdcral rqukrn ns Esudin8 asbcsros rctrrul rc rcr$plictr$lc h rhis pn,jccr
.Rlitu c.s rnd Srdc U8\ rcL{n'8 k iLinrg..trn'acri{nrNlh.rchyrurlx,irctfrc\$lrrivc\.1rhL\C-'ryrD Cornryticnrd !F)nrh.
rlitrc trf,nrion.tl Imn.ny lir i,
,\ppli$nl or Agenl Sianxl
\Aar-"t t-\1 zt-
ill $
Site-Work
Underground
Pole Bases
Light Standards
Spag, Pool, Fountains
Signs (monument)
Life Salety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bonding / Groundinq / UFER
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Faclo ry Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilings (Hard & Soflit Rouqh
Ceilinqs (T-Bar Rouoh)
Meter Release
Rough gtb r<l*Ixtr)P 4)
Service Meter tl 'ol
€rnrz //)?
Notes, Remarks, Etc
COMMENTS
Transformers
FINAL
?.rz lr. r 6
t odcrs Addrcr'.
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